Raising awareness of suicide

Suicide is the tenth leading cause of death in the United States, and in 2018, 48,344 Americans died by suicide. Globally, suicide is the second-leading cause of death among those 15 to 29 years old, according to the World Health Organization. These statistics are an alarming, but true reality that suicide is a global phenomenon; it doesn’t just occur in the United States, it occurs everywhere.

This week is Suicide Awareness Week, and now more than ever, it’s important to promote awareness and prevention strategies for suicide, to break down the stigma of mental illness, and to understand suicide warning signs, causes and prevention strategies.

What are the warning signs and symptoms of suicide?

There are many warning signs that can lead people to believe someone is thinking about suicide. According to the National Suicide Prevention Lifeline, if the following behaviors are new, or have increased, people around that person need to step in:

• Talking about wanting to die or to kill themselves
• Looking for a way to kill themselves, such as searching online or buying a gun
• Talking about feeling hopeless or having no reason to live
• Talking about feeling trapped or in unbearable pain
• Talking about being a burden to others
• Increasing the use of alcohol or drugs
• Acting anxious or agitated; behaving recklessly
• Sleeping too little or too much
• Withdrawing or isolating themselves
• Showing rage or talking about seeking revenge
• Extreme mood swings

“If somebody’s not able to do the things they’re usually able to do—maybe you see them kind of struggling to do schoolwork they’re usually able to handle or struggling to participate in a group project they’re usually able to contribute to, or struggling with a hobby or job you usually see them at—those can be indications that something’s changed,” said Bradley Bogdan, LCSW-S, clinical social work supervisor at the Department of Psychiatry and Behavioral Sciences in the Texas A&M University College of Medicine. Such changes may be an indication that the person needs help.

Still, although some people’s warning signs are very obvious and clear to others around them, signs can vary, depending on the person, and some people keep their suicidal thoughts a secret, according to the Mayo Clinic.

What are the risk factors for suicide?

There is no single cause of suicide, according to the American Foundation for Suicide Prevention. However, there are risk factors that increase a person’s chance of dying by suicide. Often suicide occurs due to a person’s feelings of hopelessness and pain, especially when health issues, environmental factors or historical factors are involved.

These are the following risk factors for suicide, according to the American Foundation for Suicide Prevention:

• Mental health conditions
  • Depression
  • Substance use problems
  • Bipolar disorder
  • Schizophrenia
  • Personality traits of aggression, mood changes and poor relationships
  • Conduct disorder
  • Anxiety disorders
• Serious physical health conditions including pain
• Traumatic brain injury
• Access to lethal means including firearms and drugs
• Prolonged stress, such as harassment, bullying, relationship problems or unemployment
• Stressful life events, like rejection, divorce, financial crisis, other life transitions or loss
• Exposure to another person’s suicide, or to graphic or sensationalized accounts of suicide
• Previous suicide attempts
• Family history of suicide
• Childhood abuse, neglect or trauma

Depression is the most common mental health condition associated with suicide. Other mental health conditions such as anxiety and substance problems also put people at an increased risk.

How can people help their loved ones who are contemplating suicide?

According to Bogdan, the biggest way to help someone who is contemplating suicide is to be open and available.

It is important to let someone contemplating suicide know that there is help available, through family and friend support, or with support services such as therapy or psychiatry. Starting a conversation about suicide, providing support and directing help to support services are the best ways to help someone who is contemplating suicide.

“Suicide is a scary thing to a lot of people and there is not necessarily a great amount of inclusion or talk about it in a lot of people’s day-to-day lives,” Bogdan said. “Being able to sit down and provide support even if somebody isn’t always able to ask for it helps a lot. Make it a regular habit of checking in with them and being able to listen to what they’re going through. Reminding them that there is that solid social contact there and somebody really cares is only going to help people.”

Many people are afraid to talk to somebody about their concerns because they’re afraid that they might precipitate a suicide, but quite the opposite is true. There is no evidence that asking somebody if they are safe or if they are okay or asking them if they are thinking about suicide leads to an increased risk of suicide, according to Bogdan.

“People feel very alone when they’re struggling with depression and anxiety, so by you just getting involved with helping them out, you’ve already lifted the burden and they’re going to feel better,” said Sheamus Kelleher, adjunct assistant professor at the Texas A&M College of Medicine who teaches a course on mental illness. “Do not wait too long because if somebody is really in crisis and especially if they’re suicidal, you have to intervene right away. You can say ‘I worry about you…are you thinking of ending your life? We love you; we want you to stay around, we want you to get help.’ If somebody is really getting distressed it’s time to ask that question and then at that stage, you need to reach out and get help for them right away.”

What are some good resources for suicide prevention?

There are many resources available at the local and national levels for suicide prevention. For students at Texas A&M, the Counseling and Psychological Services (CAPS) offers various types of counseling and support services, from consultations to individual counseling to group counseling.

In the Bryan-College Station area, there are various emergency services available. The Mental Health and Substance Abuse Crisis Hotline (1-888-522-8262) provides mental health emergency support at all hours of the day to people living in the Brazos Valley. The staff provides support, information, referrals and/or crisis intervention referrals.

In addition to those resources, the Texas A&M College of Medicine’s Department of Psychiatry and Behavioral Sciences currently treats patients through an outpatient psychiatry clinic and Telebehavioral care network.

For those living in the United States outside the Brazos Valley, the National Suicide Prevention Lifeline (1-800-273-8255) is a fantastic resource, Bogdan said. There are options for people who are hard of hearing or who speak a language other than English.

How can we break the stigma of mental illness?

Many people are too afraid to speak out about their mental health problems, which can lead to suicide, due to the stigma surrounding the topic. Some people may believe that mental illness is a sign of weakness or that having anxiety or depression is fake.

According to the National Alliance on Mental Illness, the stigma surrounding mental illness causes people to feel ashamed for something entirely out of their control and ceases people from getting the help they need.

“Just every opportunity you have, talk about mental health openly and talk about the signs,” Kelleher said. “If you see somebody struggling, talk to them. Don’t just leave them alone and walk away. Instead, be an advocate for those who are struggling.”

The following are additional ways to deal with the stigma surrounding mental illness according to the National Alliance on Mental Illness:

• Educate yourself and others
• Be conscious of language
• Encourage equality between physical and mental illness
• Show compassion for those with mental illness
• Choose empowerment over shame
• Be honest about treatment
• Let the media know when they’re being stigmatizing
• Don’t harbor self-stigma

“When you go out socially, people will talk about their dislocated shoulder or their broken arm or just about any physical ailment they have, but as soon as you mention depression, anxiety or anything like that, people get very quiet,” Kelleher said. “One of the things that I try to do is I talk about it very openly like it’s just as if it’s a normal illness, which it is. It’s just having the conversation and not being afraid to talk about it. Most people can have a good outcome and go on to live a very full life if you get the treatment, we just have to be brave enough to kind of start talking about it for what it is. It’s just another illness.”